WMJ Vol 119: Clinical Features of COVID-19 Infection in Patients Treated at a Large Veterans Affairs Medical Center
Introduction: During recent months, reports describing the characteristics of COVID-19 patients in China, Italy, and the United States have been published. Military veterans represent another unique population affected by COVID-19. This report summarizes the demographics and baseline clinical comorbidities in veterans testing positive for COVID-19 in Milwaukee, Wisconsin.
Methods: Patient evaluations were conducted at the Zablocki VA Medical Center, Milwaukee, Wisconsin between March 11 and June 1, 2020. Patient demographics, baseline comorbidities, home medications, presenting symptoms, and outcomes were obtained via electronic medical record.
Results: Ninety-five patients (88 men, 7 women) tested positive for COVID-19 and were evaluated. Fourteen required mechanical ventilation; 50 and 31 patients were treated in the hospital without ventilation or were discharged to home isolation, respectively. Discharged patients were younger than patients hospitalized. Most patients with COVID-19 were African American (63.2%). Patients whose disease progressed to mechanical ventilation had, on admission, more dyspnea, higher heart and respiratory rates, and lower oxygen saturation than other patients. COVID-19 patients who required mechanical ventilation had a longer length of stay and higher mortality than other groups and were more likely to have a history of hypertension and hyperlipidemia than patients who were discharged to home quarantine (85.7% and 78.6% vs 48.4% and 45.2%, respectively; P < 0.05 for each).
Conclusion: COVID-19-positive veterans are predominantly African American men with hypertension and hyperlipidemia receiving beta blockers or ACEi/ARB. COVID-19-positive veterans who presented with dyspnea, tachypnea, tachycardia, and hypoxemia were more likely to require endotracheal intubation and mechanical ventilation, had longer hospital length-of-stay, and experienced greater mortality than comparison groups.
The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.
As a result of this journal-based activity, learners will be able to:
- Describe the demographics and co-morbid conditions of the US military veteran population testing positive for COVID-19 and care received from the healthcare team at the Zablocki VA Medical Center in Milwaukee, WI.
- Determine how clinical symptoms documented in the emergency room, especial oxygen saturation, guided in-hospital admission of patients testing positive for COVID-19.
- Summarize how the presenting symptoms of COVID-19 positive patients on hospital admission related to their need for endotracheal intubation, mechanical ventilation, length of stay and mortality.
It is the policy of the University of Wisconsin–Madison ICEP that the faculty, authors, planners, and other persons who may influence content of this CE activity disclose all relevant financial relationships with commercial interests* in order to allow CE staff to identify and resolve any potential conflicts of interest. Faculty must also disclose any planned discussions of unlabeled/unapproved uses of drugs or devices during the educational activity. For this educational activity all conflicts of interests have been resolved and detailed disclosures are listed below:
|Name of Individual||Individual's Role in Activity|
Name of Commercial Interest &
|Terese Bailey, BS||Accreditation Specialist||No Relevant Financial Relationships to Disclose||No|
|Lauren Barta, MD||Author||No Relevant Financial Relationships to Disclose||No|
|Shannon Dugan||Author||No Relevant Financial Relationships to Disclose||No|
|David Dwyer, PhD, RN, NE-BC||Reviewer||University of Wisconsin-Madison (Employment); Eskenazi Health (Spouse/Partner: Employment); Mayo Clinic (Spouse/Partner: Employment); Indiana University (Spouse/Partner: Grant)||No|
|Thomas J. Ebert, MD, PhD||Author||No Relevant Financial Relationships to Disclose||No|
|Brian Gordon, MD||Author||No Relevant Financial Relationships to Disclose||No|
|Calvin Nguyen-Ho||Author||No Relevant Financial Relationships to Disclose||No|
|Paul S. Pagel, MD, PhD||Author||No Relevant Financial Relationships to Disclose||No|
|Seema M. Policepatil, MD||Reviewer||No Relevant Financial Relationships to Disclose||No|
|Robert J. Przybelski, MD||Reviewer||Biogen (Speaker)||No|
|Robert Treat, PhD||Editor||No Relevant Financial Relationships to Disclose||No|
|Mark Wegner, MD, MPH||Reviewer||No Relevant Financial Relationships to Disclose||No|
* The ACCME defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests.
|In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.|
Credit Designation Statements
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.
Iowa Board of Nursing accepts ANCC contact hours for nursing continuing education requirements.
Continuing Education Units
The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC Contact Hours
- 1.00 University of Wisconsin–Madison Continuing Education Hours
- 1.00 Approved for AMA PRA Category 1 Credit™
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